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Posts Tagged ‘OHIP’

ImageIt has been a pet peeve of mine for a number of years of the terrible emergency care mostly due to my personal experience of a cancer patient and observing the long waits. This prompted me to sponsor a symposium on emergency care based on process design with the people who are the best with Terri Zborowski and team at  Ellerbe Becket AECOM and Dr Todd Warden, a leading ER specialist from the US who amazing with his expertise brings the wait time down to 9 min.

What was there not to be impressed? We had eight Ontario hospitals participate and some who could not attend attend due to timing conflicts received a package. The bittersweet irony was that Ontario Long Term Care called and stated great idea but because it is free we just “don’t know what to do”. Despite the setback I continued to contact physicians across Canada and sent the info package.

Well, something must have worked because my wait time in the Toronto General Hospital or better known as TGH was only 30 mins and I was sent directly to a room. The waiting room was even clean and I noted it was divided into two sections of triage those registered and those waiting to be registered.

I was pleased with the prompt care, diagnosis and treatment. The staff did not appear hurried although one nurse thought I was a renal transplant without checking my ID band and the ER physician, Dr Salmon who was professional was running out the door when I tried to ask a question. This is one reason why I like to pay directly for care at the Mayo because then there is more of a customer patient service. This caused some problems when the pharmacist had to call back the doctor to clarify a medication as it was contraindicated as an allergy on my alert. I hate clogging up the system.

I had to chuckle when I heard a nurse in the next room telling the patient  to order pan medication because she is paying for it anyway through OHIP- it is free. So don’t hold back.

I was impressed when I left the ER well under 8 hours with my prescription in hand to see a room off to one side with big words, “Rapid Assessment” and that helped eased the clogging with triage. I am sure this was part of our input from the symposium as our diagrams clearly indicate this process, although I never knew until I was again, the patient who is the real test.

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The OHIP Appeal Board is the news more frequently as a result of cases involving prior approval for out of country medical services denied by the ministry. The main issue as Canadians we are brought up to believe that we have universal healthcare and that we will be taken care of by our government.

Unfortunately, with an aging population, decreased medical resources and long waiting lists some Canadians have looked elsewhere for healthcare including India for cardiac care and Thailand for hip replacements. We are not talking about third world care but first world care and medical care with affordable prices and no wait times making this an attractive proposition.

What is in the news today are the most tragic of stories of individuals being caught in having to leave the country for care due to a lack of experts in Canada necessity a leave such as my March 24, 2012, “Ordinary People Do Get Cancer “:
“Lisa, 34 years of age is one such person living in the Ottawa area who was living a full life when she was diagnosed with neurofibromatosis. During a routine check up in her late teens she was informed was told she had neurofibromatosis but that it was benign and if they grew she would have them removed.

Fast forward to about two years ago when Lisa was experiencing difficulty eating as the tumours had grown so large, she was unable to swallow. After seeing specialists in Canada and the USA, she was informed there was nothing that could be done. In 2009 there was clinical trials at the Mayo Clinic and she was accepted with OHIP coverage, as there was no other treatment available in Canada. Then she was informed by OHIP they would not accept it as it was termed “experimental”. The cost was $50,000 and as an average citizen there was no extra cash. Lisa is a public servant working at the Canada Border Services Agency. Family, friends and community have supported Lisa with donations on her website and it is at the $33,455.81 mark. “

Recently, Erika Crawford’s family have spent over $90,000 to have surgery for Ehlers-Danlos syndrome to stabilize her neck and if not done any fall or sudden movement could have taken or life or made her a quadriplegic. 17 years old with her whole life ahead of her and to be faced with waiting to die or as in this case her family and her community supporting her to recovery. The specialist was in Maryland, USA and this is classified as out-of-country care. The final bill from Maryland is over $90,000 and was denied by OHIP. The appeal hearing is booked for January 2013 but maybe pushed to February 2013.
There are other individuals in the news such as Brooklyn Mills, Oakville and Charlie Smith, Kingston who have been denied. With the surgery Erika has a new lease on life.
Read Susan Gamble’s article in The Brantford Expositor.
What Canadians should ask is why the OHIP Appeal Board exists as it appears it serves no purpose other than to pay representatives that they are giving a “fair hearing to Canadians”. While in actuality the members are bound by strict rules and legislative law. The board is not even allowed to make recommendations back to the government, so when you think if you do not get monetary compensation, that this will allow justice for other Canadians, it does not. This hearing is one sided. This appeal process should be overhauled or abolished as it costs taxpayers money and brings false hope to those who are seeking a fair hearing and loss of valuable time to their lives of two years at least. The sad part it is not the money in the end, but that as Canadians we are given a voice in a democratic society.

What happens to other Canadians who do not have family or a community -give them a voice in the next election. Shout loud and hard.
STOP OHIP APPEAL HEARINGS & SAVE TAX DOLLARS & LIVES

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